Cognitive Rehab Improves Functional Goals in Long COVID-Related Cognitive Impairment

A randomized clinical trial published in JAMA Network Open found that individualized cognitive rehabilitation improved goal attainment in adults with long COVID-related cognitive impairment compared with treatment as usual.

The study evaluated whether cognitive rehabilitation could improve goal attainment, cognitive outcomes, and clinical outcomes in people with cognitive impairment associated with long COVID. The authors noted that cognitive impairment is common in long COVID and can affect quality of life, income, work absenteeism, and everyday functioning, while proven treatments have remained limited.

The multicenter, single-blind trial was conducted at three sites in England between February 2023 and March 2024. Participants were adults aged 30 to 60 years with prior COVID-19 infection and objective cognitive impairment, defined as performance at least 1 standard deviation below age norms in two cognitive domains. A total of 78 participants were randomized, including 38 assigned to cognitive rehabilitation and 40 assigned to treatment as usual.

Cognitive rehabilitation consisted of ten weekly one-hour individual sessions with a trained researcher. The intervention focused on evidence-based strategies applied to three personally meaningful functional goals selected by each participant. Treatment as usual varied across participants and reflected standard care available through clinical services for long COVID.

At three months, goal attainment was significantly greater with cognitive rehabilitation than with treatment as usual, with an adjusted mean difference of 2.88 (95% CI, 2.03-3.73; P<.001; Cohen d=1.57). The effect was sustained at six months, with an adjusted mean difference of 1.72 (95% CI, 0.86-2.57; P<.001; Cohen d=0.91). The authors also reported higher goal satisfaction with cognitive rehabilitation, while no significant group differences were found for fatigue, postexertional malaise, anxiety, depression, or sleep disturbance.

The authors concluded that individualized, goal-oriented cognitive rehabilitation produced significant and sustained improvements in goal attainment among people with long COVID-related cognitive impairment. The authors said the findings may help shape how cognitive rehabilitation services are developed for people living with long COVID. 

Sources: Vanova M, Patel AMR, Scott I, et al. Cognitive rehabilitation and functional outcomes in long COVID-related cognitive impairment: a randomized clinical trial. JAMA Netw Open. 2026;9(7):e2620687. doi:10.1001/jamanetworkopen.2026.20687